- See
Human Bite:
- Bacteria Sensitive to Augmentin / Unasyn
-
staph aureus
- along w/ streptococcus is the most common inciting organism in hand infections;
-
streptococcal Gr A beta hemolytic
- shows cellulitis, lymphangitis, lymphadenopathy, fever, and a systemic toxic reaction;
- in general, none of the Gr A organisms are resistant to penicillin or tetracycline, however, non Gr A organisms may be resistant;
-
symbiotic infections:
-
erysipelothrix rhusiopathiae - Streptothrix -
-
pateurella multocida:
-
bacillus anthracis:
-
eikenella corrodens:
-
neisseria gonorrhoeae:
- may produce a tenosyovitis or arthritis difficult to differentiate from the usual pyogenic infection;
- smear for diplococcus and culture on special media may aid in dx;
-
penicillin is used for treatment;
- treponema pallidum:
- may cause a primary lesion that could be mistaken for a paronychia;
- tertiary lesions may involve tendon sheaths, bone, and joint;
-
actinomyces bovis
- enters thru an abrasion on the skin, assoc. w/ cattle, swine ect;
- granuloma occurs that resembles TB, & sinus formation results;
- infection may be resent to treatment;
- treatment includes penicillin and potassium iodide;
- Misc Infections:
-
myobacterium tuberculosis:
- may cause finger joint involvement as well as tenosynovitis or sking or bone lesions;
- tuberculosis dactylitis is usually seen in children;
-
myobacterium marinum:
-
vibrio vulnificus:
-
blastomyces dermatitidis:
- may occur in the fingers as a pustule that becomes larger and spreads peripherally;
- center heals, leaving a central scar with a spreading perimeter;
- if osseus lesions occur in the digits, they may be secondary to to pulmonary disease;
- treatment is with dihydrosystilbamidine or amphotericin B;
- aeromonas hydrophila: freshwater bacteria;
-
sporotrichum schenckii:
- is a fungus that may be introduced into the extremity thru abrasions caused by thorns;
- common in those who handle soil and plants;
- delayed dx is common
- 4 months for lymphocutaneous form
- 25 months for deep infections (requires Ampho B or Ketoconazole)
- abscess develops and spreads to the regional lymphatics, resulting in multiple granulomas, which occur along the course of
the lymphatics, and ulcerate as the area is ruptured;
- potassium iodide is the drug of choice;
- coccidioides immitis
- may involve the hand and the ulnar and
radial bursae;
- it is an uncommon infection;
- Viral Infections:
- lymphogranuloma vereeum: transmitted by a bite or scratch;
-
herpes
Abscesses secondary to parental abuse of drugs.
A study of demographic and bacteriologic characteristics.
SB Schnall et al.
JBJS Vol 76-A. 1994. p 1526-1530.
Bacterial colonization of mutilating hand injuries and its treatment.
